A 2-Year Longitudinal Analysis of the Relationships Between Violent Assault and Substance Use in Women

Reviewed by
Priscilla Schulz, LCSW

from an article of the same title by:
Dean G. Kilpatrick, Ron Acierno, Heidi S. Resnick, Benjamin E. Saunders, and
Connie L. Best
Medical University of South Carolina

Journal of Consulting and Clinical Psychology,
V. 65 (5), 834-847, 1997

What is the purpose of this study?

Violence and substance abuse are major problems in the lives of many U.S. women. Research reveals that compared to men, women endure proportionately greater levels of high-severity traumatic events and approximately 20% will experience a violent physical assault or completed rape in their lives. Numerous authoritative studies also show a substantial association between a history of substance abuse and a history of violent assault among women. Within this context, the present study asks three questions.

    1. Does substance use and abuse by women lead to violent assaults?
    2. Does assault lead to substance use problems among women?
    3. Is there a reciprocal relationship between substance use/abuse and violent assault that places women in a vicious cycle of victimization and substance abuse to cope with posttrauma reactio

How does the study address these questions to give us reliable information about causality?
This study used data from the National Women's Study. At three points over the course of two years, a randomly selected, nationally representative sample of women in the U.S. were interviewed by telephone regarding substance use and abuse (both alcohol use and illicit drug use) and experiences of violent assaults including rape. Seventy-five percent of women participants completed the longitudinal study (i.e., completed three telephone interviews). Collecting data on new assaults, and new or increased substance abuse, over the course of two years allowed researchers to explore the issue of causality by noting the temporal sequence of events (e.g., Did substance abuse precede assault? Do women with no substance use/abuse history begin abusing after an assault?).

What are the study's findings?

    1. Drug abuse increases women's risk of being assaulted. Women drug abusers were almost twice as likely as non-abusers to be assaulted during the study.
    2. The experience of assault plays a significant role in escalating both alcohol and drug use in women, even in women who did not have a history of alcohol or drug abuse. However, women were more likely to turn to alcohol abuse than drug abuse after an assault.
    3. An assault history made women 5 times more likely to experience a new assault during the three years of the study.
    4. Youth and ethnic-minority status was significantly related to risk of being assaulted.
    5. Risk of new victimization was greatest in women who used drugs and had been previously assaulted. This finding in particular supported the idea that substance use and assault were in a vicious cycle with one another.

What are the implications of this study?

    1. Screening for and treating illicit drug use in women assault victims may reduce their risk of future victimization besides improving their overall mental and physical health.
    2. Interventions for women victims of violent assault should not be limited to treating trauma symptoms (e.g., PTSD, anxiety, depression), but should also address development or exacerbation of substance abuse, in particular, alcohol abuse.
    3. The treatment of women substance abusers should include screening and treatment for prior experiences of violent assault.

Reviewed by Priscilla Schulz, September 1999

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